438 DEPARTMENT OF SURGERY. 
against infection (theoretically), providing that the stitches 
do not slacken before the edges have united. If Czerny’s su¬ 
ture is selected it should be made with good catgut, well steril¬ 
ized ; in fact, all approximations sutured with a single series of 
stitches must be made of catgut, but those to which a secondary 
series is applied, the inner can be made of silk or linen, and 
the outer one of catgut. The stitches should be ligated care¬ 
fully, applying uniform tension to all those included in each 
series respectively and tying them with a sailor’s knot (Fig. 
9 - 0 - 
When the intestinal operation is completed the cavity 
should be well irrigated with warm water ; and, when thor¬ 
oughly cleaned, the intestine replaced. In returning the intes¬ 
tine, care should be taken not to place it in an abnormal posi¬ 
tion and not to leave any foreign bodies in the cavity. We 
can recall a case that died almost a year after an abdominal 
operation, and upon post-mortem examination a pair of artery 
forceps were found in the abdominal cavity ; and there are 
other instances where sponges and tampons have been left in 
the cavity. It is therefore advisable to count the sponges, 
tampons and instruments before the operation, and again before 
the cavity is closed, for such mistakes and oversights are a dis¬ 
credit to the surgeon. Being satisfied that the cavity is thor¬ 
oughly cleansed, and all instruments, sponges and tampons re¬ 
moved, the abdominal incision is then sutured in the same man¬ 
ner as in celiotomy. 
After-care .—The first thing that should receive attention is 
shock, and must be treated as shock following other operations ; 
peristalsis must be arrested ; pain relieved ; thirst must be 
quenched by administrating small quantities of lukewarm 
water, sponging the mouth and by the administration of an 
occasional nutritious enema ; sepsis should be treated by sub¬ 
cutaneous injections of a normal salt solution, cold application, 
and if the temperature keeps on rising the cavity should be re¬ 
opened and the septic products removed and parts well irri¬ 
gated with antiseptics ; and food should be withheld for the 
first two or three days, and at first should be given in very 
small quantities. The temperature should be carefully 
watched for the first three or four days ; a sudden rise is an in¬ 
dication of sepsis, and the treatment should be as the conditions 
demand. 
4. Enterotomy .—This is an operation that is of more 
importance to the veterinarian than other intestinal opera- 
